Renal/GU Flashcards
Fatty casts
Nephrotic syndrome
Broad waxy casts
Chronic renal failure
WBC casts
Interstitial nephritis or pyelonehritis
RBC casts
glomerulonephritis
Muddy brown casts
ATN
Path in hypertensive nephropathy?
Diabetic nephropathy?
HTN: Hyaline arteriosclerosis in afferent arteriole only, glomerular tufts
DM: Hyaline arteriosclerosis in both afferent and efferent arteriole, glomerulosclerosis (nodular or diffuse) increased ECM/fibrosis, thick BM, and mesangial expansion
First renal abnormality in diabetic nephropathy? First thing noticeable on pathology?
First thing: Glomerular hyperfiltration
Biopsy: GBM thickening
Nodular glomerulosclerosis
Specific to diabetic nephropathy (K-W nodules will be seen)
Although diffuse glomerulosclerosis is more common in diabetic nephropathy
Type of acid-base abnormality that can be seen in elderly, poorly controlled diabetics
Type IV RTA (dysfunctional JG apparatus leads to hyporeninemic hypoaldosterone)
Most common form of HIV-associated kidney disease
FSGS (also associated with obesity, heroin, and AA race)
Kidney disease associated with hepatitis B
Membranous nephropathy (also seen in SLE, adenocarcinoma, NSAIDs)
Kidney disease associated with hepatitis C
Mempranoproliferative glomerulonphritis
BUN/Cr, urine osmolarity, and urine sodium in ATN
BUN/Cr < 20 (intrinsic AKI)
Urine osmolarity 300-350 (inability to concentrate urine)
Urine Na >20, FeNa >2%
Kidney injury with acyclovir
Crystal-induced nephropathy (also seen with ethylene glycol, sulfonamides, methotrexate, protease inhibitors)
Renal disease classically associated with renal artery thrombosis
Membranous nephropathy (but any nephrotic syndrome can cause, due to hypercoagulability)
Nephrotic syndrome with restrictive cardiomyopathy, organomegaly, macroglossia, easy bleeding/bruising
AA amyloidosis (in chronic inflammatory state)
Also can see waxy skin thickening, neuropathy and stroke. Easy bleeding/bruising due to fragile vessels
Hypertension, microhematuria, and a palpable right flank mass
ADPKD (both kidneys enlarged, but easier to palpate on right)
Time course and complement in:
- IgA nephropathy
- Post-infectious glomerulonephriti
IgA: Synpharyngitic, normal complement
Post-infectious GN: Delayed 10-21 days, low complement
Nephritis with eosinophiluria or eosinophilia
Allergic interstitial nephritis
(Commonly due to drugs like cephalosporins, penicillins, sulfonamides, diuretics, NSAIDs, rifampin, phenytoin, allopurinol. Stop the drug to treat).
Analgesic nephropathy
Chronic NSAIDs leading to tubulointerstitial nephritis (WBC casts) and/or papillary necrosis (hematuria)
How can calcium and phosphorous go wrong in CKD?
Secondary hyperparathyroidism due to hypocalcemia (vitamin D deficiency) and hyperphosphatemia (phosphate retention in the kidney)
Treatment for uremic platelet dysfunction
DDAVP (increases levels of factor VIII/vWF that activates platelets)
Most common side effect of EPO in CKD
Worsening HTN (HA and flulike symptoms can also be seen)
Treatment for uric acid kidney stones
Acidify the urine with oral potassium citrate (uric acid stones only form in patients with unusually alkaline urine)
